tbuckley/cabot-search huggingface dataset:
Prognostic factors of long-term outcomes after primary chemo-radiotherapy in non-metastatic anal squamous cell carcinoma: An international bicentric cohort.
Authors: Soledad Iseas, Diego Martín Prost, Sarah Bouchereau, Mariano Golubicki, Juan Robbio, Ana Oviedo, Mariana Coraglio, Marcela Carballido, Mirta Kujaruk, Guillermo Mendez, Mario Edmundo Barugel, Enrique Roca, Louis Gros, Vincent de Parades, Nabil Baba-Hamed, Julien Adam, Martin C Abba, Eric Raymond
Journal: Journal of Clinical Oncology (2023)

e15501 Background: Anal squamous cell carcinoma (ASCC) is a rare malignancy with a rising incidence associated with Human papillomavirus (HPV) infection. Locally-advanced disease is associated with a 30% rate of treatment failure after standard chemoradiotherapy (CRT). We aimed to elucidate prognostic factors for ASCC after curative CRT. Methods: A retrospective multicenter study of 176 consecutive patients with ASCC having completed CRT treated between 2010 and 2017 at 2 centers. Complete response (CR), disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan–Meier estimates with log-rank tests. The hierarchical clustering on principal components (HCPC) method was employed in an unsupervised and multivariate approach. Results: CR rate was 68% and was predictive of DFS (p &lt; 0.0001) and OS (p &lt; 0.0001), where non-CR cases were associated shorter DFS (HR = 16.5, 95% CI 8.19-33.21) and OS (HR = 8.42, 95% CI 3.77–18.81) in univariate analysis. Median follow-up was 38 months, with 3-year DFS of 71%. Prognostic factors for DFS were cT1-T2 (p = 0.0001), N0 (p = 0.03), HIV-positive (p = 0.04), HIV-HPV coinfection (p = 0.02), and well-differentiated tumors (p = 0.03). Three-year OS was 81.6%. Female sex (p = 0.05), cT1-T2 (p = 0.019), and well-differentiated tumors (p = 0.003) were associated with better OS. This unsupervised analysis demonstrates clear segregation, identifying that poor prognosis clusters associated with shorter DFS (HR = 1.66, 95% CI = 1.21–2.27, p = 0.0012) were enriched with locally-advanced disease, anal canal location, HPV-HIV coinfection, and non-CR. Conclusions: In conclusion, our results reinforce the prognostic value of T stage, N stage, sex, differentiation status, tumor location, and HIV-HPV coinfection in ASCC after CRT.
Use and value of self-management (SM) recommendations in a real-world evidence study evaluating digital patient monitoring (DPM) of patients (pts) receiving cancer care.
Authors: Manuela Eicher, Marika Bana, Karin Ribi, Sophie Schneider, Johannes Ammann
Journal: Journal of Clinical Oncology (2023)

1603 Background: SM includes pts’ abilities and activities to manage symptoms, treatment (tx), and any problems inherent to a chronic condition. Tailored SM support is recommended in cancer care. DPM enables pts to systematically self-report disease- or tx-related symptoms, communicate directly with healthcare professionals (HCPs), and access support materials. This observational study evaluated the real-world use of the Symptom Navi Program (SNP; Bern, Switzerland) SM materials on the Kaiku Health DPM platform (Helsinki, Finland) in collaboration with F. Hoffmann-La Roche Ltd (Roche; Basel, Switzerland). Methods: Adults diagnosed with locally advanced or metastatic non-small/small cell lung cancer, or any stage HER2-positive breast cancer being treated with locally approved and reimbursed drugs with an expected tx duration of &gt;3 months, had access to a DPM solution that provided disease- and tx-tailored modules, including SNP SM recommendations for selected mild or moderate symptoms. The co-primary endpoints were DPM adoption and adherence. Here we report secondary endpoints; the perceived clinical impact, DPM module and service experience (assessed via Customer Effort Score [CES] and Customer Satisfaction Score [CSS]), and use of DPM features such as SM recommendations, via a DPM tool questionnaire. Results: Of the 89 enrolled pts, 66 had completed the DPM tool questionnaire at Week 6 of DPM use (data cutoff: June 9, 2022). Among the educational content, the symptom feedback library was accessed most. Pts spent up to a median of 12 minutes on Roche educational or SNP SM materials. The majority of pts (45/66 [68%]) considered the symptom questionnaires to cover all/most of the symptoms they experienced; 18/66 (27%) experienced only fair/partial symptom coverage; 49% (25/51) of pts whose symptoms were not covered contacted their HCP team. 34 pts (52%) took action based on the symptom questionnaire feedback; the most common action was SM recommendations applied according to symptom level (21/66 [32%]), followed by sending a message via the platform to the care team (8/66 [12%]). Half of pts found the SNP SM recommendations helpful/very helpful and 22 pts agreed that the SNP SM recommendations almost always/sometimes supported them in delaying contacting an HCP at an emergency room. At Week 6, the CES was 80%, CSS was 71%, and 48% (32/66) of pts felt that this service improved their care. Conclusions: Pt feedback showed that SNP SM recommendations were the most used action in response to the symptom questionnaire feedback and were perceived by most to be helpful/very helpful. These results support the use of SM recommendations in pts with cancer to help them self-manage tx-related symptoms experienced; future studies are needed to further explore their impact and usefulness, and to form recommendations for routine use in clinical practice.
Rates of hematologic toxicity in WBRT vs SRS.
Authors: Aliah McCalla, Rituraj Upadhyay, Haley Kopp Perlow, Raju R. Raval, Dukagjin Blakaj, John C. Grecula, Joshua David Palmer, Evan Marshall Thomas
Journal: Journal of Clinical Oncology (2023)

e14014 Background: Whole brain radiotherapy (WBRT) has historically been a standard of care in patients with multiple brain metastases. Studies show WBRT may be associated with a transient detriment in hematological parameters because of exposure to a larger proportion of circulating lymphocytes, platelets and hematopoietic cells within the bone marrow of the cranium. We tested the hypothesis that stereotactic radiotherapy (SRS) has reduced hematologic toxicity in patients compared to WBRT. Methods: We retrospectively identified 100 patients treated for brain metastasis, with either SRS or WBRT from 2016 to 2019, and queried their pre- and post-treatment hematological parameters including hemoglobin, total white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count, and platelet count. CTCAE v5.0 was used for grading hematologic toxicities. Serial values were compared by treatment type and controlled for age, gender, &amp; systemic therapy. Student t-test was used for intergroup comparison and p-value &lt;0.05 was considered significant. Results: Of 100 patients, median brain metastases was 3 (range 1-22), 51 received SRS and 49 received WBRT. We observed that patients treated with WBRT had a significantly higher post-treatment reduction in platelet count (-51.2 vs 9.8; p=0.001) and higher incidence of any grade thrombocytopenia (31.2% vs 10%; p=0.019) compared to patients treated with SRS. We also noted that compared with SRS, WBRT was associated with a higher post-treatment reduction in circulating lymphocytes (-0.80 vs 0.14; p = 0.071) and higher incidence of G3+ lymphopenia (43.2% vs 22.2%; p=0.07). Numerical incidence of any G3+ hematological toxicity was also higher in the WBRT group but the difference was not statistically significant (40% vs 28%, p=0.162). Hemoglobin count, WBC, and ANC were not meaningfully different pre- and post-treatment for either group. Conclusions: WBRT results in an increased amount and duration of radiation exposure to circulating intracranial blood volume. In our study, patients treated with WBRT experienced higher rates of clinically significant lymphopenia &amp; thrombocytopenia compared to patients treated with SRS. In addition to the cognitive benefits of SRS compared to WBRT, there may be significant hematologic benefits as well. Further studies are warranted to clarify and validate these findings. [Table: see text]
Evaluation of THEO-260 as a novel oncolytic virus therapy for treating stromal rich tumours.
Authors: Jonathan Krell, Sally Frost, Caterina Negroni, Chiara Moriconi, William Taverner, Brannon Nicholls, Deanna Saunders, Paula Cunnea, Christina Fotopoulou, Alfred Lim, Miriam Bazan-Peregrino, Kerry Fisher, Margaret R Duffy
Journal: Journal of Clinical Oncology (2023)

e14573 Background: Stromal rich tumours pose a significant challenge to the effectiveness of systemic anticancer therapies, including immunotherapies and oncolytic viruses. This is due to the abundance of cancer associated fibroblasts (CAFs) that suppress immune cells and limit drug penetration. THEO-260 is a potent, mechanistically novel oncolytic virus therapy intrinsically capable of lysing both cancer cells and CAFs, and is currently in development for late stage relapsed refractory ovarian cancer. Methods: The efficacy and safety of THEO-260 was assessed in multicellular spheroids, in patient-derived ex vivo fresh ovarian samples and in mouse models of human stromal tumours. Results: Unpassaged ascites and tumour samples collected from cytoreductive surgeries for advanced ovarian cancer (n=24 independent patients) were treated with a clinically-relevant dose of THEO-260. THEO-260 effectively killed the cancer cell (EpCAM+ EGFR+PDL1+ CA125+) and CAF (FAP+) populations, being efficacious in treatment-naive and platinum-resistant patient samples. Importantly, the T cell population in these patients, in addition to primary normal fibroblasts (including intestinal, pulmonary, dermal, cardiac, uterine fibroblasts) from healthy donors, were not damaged. Ex vivo studies show THEO-260 stimulates effector T cell responses upon tumour lysis as indicated by IFNγ release. Demonstrating suitability as an IV delivered agent, THEO-260 was active in pooled human serum and whole human blood (n = 10 donors). THEO-260 excels in low nutrient, low proliferative environments, typical of human solid tumours and has been developed with a view to persist in the tumour microenvironment without the need for repeated cycles of delivery. THEO-260 is well tolerated in vivo following a clinically relevant intravenous dosing regimen. In PARP inhibitor and platinum resistant ovarian cancer murine models containing human CAFs and cancer cells, THEO-260 shows antitumor efficacy, with a complete reduction in tumour volume in subcutaneous and intraperitoneal systems, and superiority to SOC. Virus activity is not restricted to ovarian cancer, with cell line data demonstrating killing in additional solid tumour types, including pancreatic, colorectal, lung, and breast cancer. THEO-260 exhibits genetic and temperature based stability, and GMP manufacturing to high yields is underway. Conclusions: Taken together, we present a preclinical data package for THEO-260 supporting progression to Phase I clinical trials.
Talazoparib (TALA) plus enzalutamide (ENZA) in metastatic castration-resistant prostate cancer (mCRPC): Safety analyses from the randomized, placebo (PBO)-controlled, phase 3 TALAPRO-2 study.
Authors: Arun Azad, Karim Fizazi, Nobuaki Matsubara, Fred Saad, Ugo De Giorgi, Jae Young Joung, Peter C.C. Fong, Robert J. Jones, Stefanie Zschaebitz, Jan Oldenburg, Neal D. Shore, Curtis Dunshee, Joan Carles, Andre P. Fay, Xun Lin, Liza L DeAnnuntis, Nicola Di Santo, Arne Engelsberg, Neeraj Agarwal
Journal: Journal of Clinical Oncology (2023)

5053 Background: The phase 3 TALAPRO-2 study demonstrated a clinically meaningful and statistically significant improvement in radiographic progression-free survival for 1st-line TALA + ENZA versus PBO + ENZA in men with mCRPC, unselected for homologous recombination repair gene alterations (all-comers population). Here, we detail the safety profile of TALA + ENZA. Methods: In this double-blind, randomized, PBO-controlled trial, men received TALA 0.5 mg or PBO, plus ENZA 160 mg once daily (QD). Patient (pts) were ≥18 yrs of age, had Eastern Cooperative Oncology Group performance status ≤1, were receiving ongoing androgen deprivation therapy, and had no prior systemic therapy for mCRPC. Treatment-emergent adverse events (TEAEs) were evaluated: type, severity, timing, and associated dose modifications/discontinuations. Results: The all-comers safety population included 398 pts in the TALA + ENZA arm. Data cutoff was August 16, 2022. The median treatment duration of TALA was 19.8 months. All-cause any-grade TEAEs were observed in 98.5% of pts. Overall, 19.1% of pts discontinued TALA due to TEAEs. The 3 most common hematologic all-cause TEAEs and associated dose modifications are reported. To ensure optimal dosing of TALA at the individual level, the protocol did not require dose modification of TALA until anemia was grade (G) ≥3. Median time to onset of first G≥3 anemia was 3.3 months. At study entry, 49.0% had G1–2 anemia. 43.2% had anemia leading to dose reduction (with or without transfusion) and 8.3% discontinued TALA due to anemia. Despite dose reduction, the relative dose intensity of talazoparib remained &gt;80% (approx. 0.4 mg/day). The 3 most common nonhematologic TEAEs were fatigue (33.7%; 4.0% G3), back pain (22.1%; 2.5% G3), and decreased appetite (21.6%; 1.3% G3). Conclusions: TALA 0.5 mg QD + ENZA 160 mg QD was generally manageable, with dose modifications of TALA and/or standard supportive care. Anemia was the most common TEAE and led to discontinuation of TALA in 8.3% of pts. G≥3 hematologic AEs typically occurred within 6 months of starting therapy and resolved in &lt;1 month. A detailed understanding of the onset, duration, and severity of AEs, as well as the impact of dose adjustments in the TALAPRO-2 study, will optimize the management of pts receiving TALA + ENZA for mCRPC. Clinical trial information: NCT03395197 . [Table: see text]
KEYNOTE-826: Final overall survival results from a randomized, double-blind, phase 3 study of pembrolizumab + chemotherapy vs placebo + chemotherapy for first-line treatment of persistent, recurrent, or metastatic cervical cancer.
Authors: Bradley J. Monk, Nicoletta Colombo, Krishnansu Sujata Tewari, Coraline Dubot, M. Valeria Caceres, Kosei Hasegawa, Ronnie Shapira-Frommer, Pamela Salman, Eduardo Yañez, Mahmut Gumus, Mivael Olivera Hurtado de Mendoza, Vanessa Samouëlian, Vincent Castonguay, Alexander Arkhipov, Cumhur Tekin, Kan Li, Stephen Michael Keefe, Domenica Lorusso
Journal: Journal of Clinical Oncology (2023)

5500 Background: The first interim analysis of KEYNOTE-826 (NCT03635567) showed that first-line pembrolizumab (pembro) + chemotherapy (chemo) provided statistically significant and clinically meaningful improvements in OS and PFS vs placebo (pbo) + chemo in patients (pts) with recurrent, persistent, or metastatic cervical cancer across all prespecified populations (PD-L1 combined positive score [CPS] ≥1, all-comer, and CPS ≥10). Here, we present the protocol-specified final OS analysis results of KEYNOTE-826. Methods: Eligible adults with persistent, recurrent, or metastatic cervical cancer not previously treated with systemic chemo (prior radiosensitizing chemo allowed) and not amenable to curative treatment (surgery or radiation) were randomized 1:1 to pembro 200 mg or placebo Q3W for up to 35 cycles + chemo (paclitaxel 175 mg/m 2 + cisplatin 50 mg/m 2 or carboplatin AUC 5), ± bev 15 mg/kg. Pts were stratified by metastatic status at diagnosis (yes/no), planned bev use (yes/no), and PD-L1 CPS (&lt;1, 1 to &lt;10, or ≥10). Dual primary end points were OS and PFS per RECIST v1.1 assessed by investigator review, each tested sequentially in the PD-L1 CPS ≥1, all-comer, and CPS ≥10 populations. Results: From Nov 2018 to Jan 2020, 617 patients were randomized (pembro + chemo, n = 308 [63.6% with bev]; pbo + chemo, n = 309 [62.5% with bev]); 548 (88.8%) pts had PD-L1 CPS ≥1 and 317 (51.4%) had CPS ≥10. At the Oct 3, 2022 data cutoff, median follow-up was 39.1 mo. Pembro + chemo significantly improved OS and PFS in the CPS ≥1, all-comer, and CPS ≥10 populations (Table). The pembro + chemo benefit was seen regardless of bev use. Grade ≥3 AE incidence was 82.4% in the pembro + chemo arm and 75.4% in the placebo + chemo arm. The most common grade ≥3 AEs were anemia (30.3% vs 27.8%), neutropenia (12.4% vs 9.7%), and hypertension (10.4% vs 11.7%). Conclusions: The addition of pembro to chemo ± bev significantly reduced the risk of death by 40% in the PD-L1 CPS ≥1 population, by 37% in the all-comer population, and by 42% in the CPS ≥10 population, and had a manageable safety profile. These data are consistent with the earlier results and provide further support for pembro + chemo ± bev as a new standard of care for first-line treatment of persistent, recurrent, or metastatic cervical cancer. Clinical trial information: NCT03635567 . [Table: see text]
A novel prognostic model for high-grade endometrial cancer using combined neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR).
Authors: Zhaoyang Zhang, Ran Chu, Beihua Kong, Gang Chen, Yang Li, Kun Song
Journal: Journal of Clinical Oncology (2023)

e17622 Background: Endometrial carcinoma (EC) as a common malignant tumor of the female reproductive system, posing a serious threat to the health of women. Compared to low-grade EC, high-grade EC has more rapid progression and a worse prognosis. Among the high-grade EC, grade3 endometrioid carcinoma, serous carcinoma, and clear cell carcinoma were the most common. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are potential biomarkers of the systemic inflammatory response, and the correlation with prognosis of high-grade EC remains unclear. We want to evaluate the predictive significance of NLR and PLR in the prognosis of high-grade endometrial carcinoma and to establish a predictive model combining clinical factors. Methods: This multicenter retrospective cohort study included 910 high-grade epithelial endometrial carcinoma patients from the Chinese Endometrial Carcinoma Consortium database who underwent initial surgical treatment between January 1, 2005, and December 31, 2019. Univariable Cox survival analysis(the 2-sided Log-rank test) was used to assess each factor. Then the least absolute shrinkage and selection operator (LASSO) method was used to select the independent risk factors for DFS (disease-free survival) and OS (overall survival) from the outcomes of the univariate analysis to proceed with model fitting. Cox proportional hazard regression models were developed to predict the risk of recurrence and death at 3, 5, and 10 years, and the models were validated and calibrated. The area under the curve was used to measure the predictive performance of the model. The decision curve analysis was used to explore the clinical net benefit of the nomograms. Results: NLR and PLR were risk factors for recurrence, and NLR was a risk factor for death. We established models for predicting death and recurrence. In the training cohort, the AUC of recurrence model at 3, 5 and 10-year was 0.85, 0.85 and 0.86. And for the death model, the AUC at 3, 5 and 10-year was 0.83, 0.84 and 0.86. In the validation cohort, the AUC of recurrence model at 3,5 and 10-year was 0.72, 0.77 and 0.77. And for death model was 0.72, 0.81 and 0.84. Kaplan–Meier survival analysis showed a significant difference between low-risk and high-risk groups. The calibration curve also revealed excellent predictive accuracy both in the training and validation cohort. Conclusions: NLR and PLR are risk factors affecting the prognosis of high-grade endometrial carcinoma patients. Combining NLR/PLR and clinicopathological factors, we established a novel and more comprehensive prognostic model for patients to achieve risk stratification. This prognosis predictive model has the potential to offer risk scores and precise risk stratification for patients with high-grade endometrial cancer.
INB-200 phase I study of gene modified autologous gamma-delta (γδ) T cells in patients with newly diagnosed glioblastoma multiforme (GBM) receiving maintenance temozolomide (TMZ).
Authors: Mina Lobbous, Trishna Goswami, Lawrence S. Lamb, Kate Rochlin, Thriumaine Pillay, Samantha Youngblood, Mariska ter Haak, Louis B. Nabors
Journal: Journal of Clinical Oncology (2023)

2007 Background: MHC unrestricted γδ T cells target NKG2D ligands upregulated on tumor cells. IN8bio’s DeltEx chemotherapy resistant cell therapy (CRCT), is a novel γδ T cell genetically engineered to express MGMT to convey temozolomide (TMZ) resistance and allow combination therapy. NCT04165941, a Phase 1 trial assessing the safety of single and multiple infusions of autologous CRCT cells presents updated safety and efficacy data. Methods: Adult newly diagnosed GBM patients with adequate organ function and KPS≥70% are enrolled. Cells engineered from apheresis were infused through a Rickham catheter placed during surgery. Cohorts (C) 1, 2 and 3 each receive 1, 3 and6 doses of cells respectively on day (D) 1 of each 28-day maintenance cycle. Patients receive 1 x 10 7 γδ T cells intratumorally with 150 mg/m 2 of TMZ intravenously on D1 of maintenance with the standard Stupp maintenance regimen on D2-5. Primary endpoint is safety; secondary endpoints include progression free and overall survival. Immunologic and genomic correlative analyses are being conducted. Dose limiting toxicities (DLTs) are defined as treatment related ≥ grade 3 cardiopulmonary or hepatic toxicity, grade 4 toxicity exceeding 72 hours or neurologic deterioration that exceeds 2 weeks. Results: 15 patients (53% male; median age 69 (range: 21-76); 80% IDH-WT, 66.7% MGMT unmethylated) were enrolled with 8 dosed (N=3 in C1, 4 in C2, 1 in C3). No patients experienced DLTs, cytokine release syndrome (CRS), or neurotoxicity (ICANS). The most common adverse events (AEs) were Grade 1/2 events including fever, fatigue, nausea, headache, platelet count decreased, incision site pain attributable to TMZ, radiotherapy or disease. One subject had Grade 3 treatment related AEs of UTI, dehydration, and thrombocytopenia. Three evaluable C1 patients have PFS of 8.3, 11.9, 7.4 months and OS of 15.6, 17.7 and 9.6 months respectively. In C2, four patients have been dosed, with no DLTs in 3 evaluable patients; 2 remain progression free at 18.9 and 14.8 months, while a third died without relapse due to pulmonary embolus at 8.7 months. One C3 patient has completed 5 of 6 planned doses without DLT. Patient recruitment continues with anticipated completion in 2023. Conclusions: Data demonstrates that single, repeat doses of CRCT gamma delta T cells have manageable toxicity with continued encouraging trend in PFS and warrants further assessment. Clinical trial information: NCT04165941 .